Individual provider Active NPI

Mark Quieng Sy, RPT

  • Physical Therapist
  • Lakewood, CA
National Provider Identifier
1730378670
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT29201 Issued in CA
Practice address
6322 Michelson St
Lakewood, CA 90713-1710
Phone
(562) 303-6367
NPI assigned
Oct 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT29201 CA Primary

Addresses

Primary practice location

6322 Michelson St
Lakewood, CA 90713-1710

Mailing address

2051 Owens Dr
Fullerton, CA 92833-5750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29201CAMDGeneral Practice Dentistry
PT29201CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mve Home Health Care LLC CurrentSince Apr 13, 2024 Accepting new patients
Functional Rehabilitation Physical Therapy PC Physical Therapist PastSince Jul 1, 2021 Accepting new patients
Rehabilitation Dynamics Inc Physical Therapist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1730378670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 OWENS DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928335750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6322 MICHELSON ST",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131710",
            "telephone_number": "562-303-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SY",
        "first_name": "MARK",
        "middle_name": "QUIENG",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT29201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.